Clinicopathologic features and outcomes in patients with diffuse sclerosing variant of papillary thyroid carcinoma

Junko Akaishi, Kiminori Sugino, Kaori Kameyama, Chie Masaki, Kenichi Matsuzu, Akifumi Suzuki, Takashi Uruno, Keiko Ohkuwa, Hiroshi Shibuya, Wataru Kitagawa, Mitsuji Nagahama, Kazuo Shimizu, Koichi Ito

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18 Citations (Scopus)

Abstract

Background: Diffuse sclerosing variant (DSV) of papillary thyroid carcinoma (PTC) is a rare variant more common among younger patients. Materials and methods: Excluding patients with microcarcinoma, 5848 patients with PTC underwent initial surgery between 1995 and 2011. Twenty-two patients (0.4 %) were histologically diagnosed with DSV, of whom 20 (91 %) were <45 years old. We compared clinicopathologic characteristics and outcomes between patients with DSV and those with classical PTC <45 years old. Univariate analysis by the Kaplan-Meier method in relation to cause-specific survival (CSS) and disease-free survival (DFS) rates was performed with regard to the following variables: sex; anti-thyroglobulin antibody (TgAb) positivity; presence of distant metastasis; pathological lymph node metastasis; extra-thyroidal invasion; and pathological variant (classical vs. DSV). Results: The 20 patients with DSV <45 years old comprised 18 females and 2 males. Frequencies of TgAb, pN1b, and local recurrence were higher in the DSV group than in the classical PTC group. Ten-year CSS and DFS rates for PTC patients <45 years old were 99.7 and 88.6 % in the classical PTC group and 100 and 60.5 % in the DSV group. CSS rate did not differ between groups, but DFS rate was significantly lower in the DSV group than in the classical PTC group (p < 0.0001, log-rank test). Multivariate analysis identified DSV group and pN1b as prognostic factors for recurrence in young PTC patients. Conclusions: Most DSV patients were young and had a background of chronic thyroiditis. Outcomes for DSV were very good, but recurrence was more common than in classical PTC.

Original languageEnglish
Pages (from-to)1728-1735
Number of pages8
JournalWorld Journal of Surgery
Volume39
Issue number7
DOIs
Publication statusPublished - 2015 Jul 5

ASJC Scopus subject areas

  • Surgery

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    Akaishi, J., Sugino, K., Kameyama, K., Masaki, C., Matsuzu, K., Suzuki, A., Uruno, T., Ohkuwa, K., Shibuya, H., Kitagawa, W., Nagahama, M., Shimizu, K., & Ito, K. (2015). Clinicopathologic features and outcomes in patients with diffuse sclerosing variant of papillary thyroid carcinoma. World Journal of Surgery, 39(7), 1728-1735. https://doi.org/10.1007/s00268-015-3021-9